Research Methods in Rehabilitation

Part 1: Ethics
- Philosophical ethics and role ethics
- content and function of ethical codes in the health professions.
Part 2 - Medical bioethics
- Health rights, informed consent
- role of Ethics Committees as concerns healthcare treatments and biomedical research

- Cumulative questionnaires: typical structures.
Visual analogues and mono-item questionnaires (numeric rating Scales); Multi-item scales like likert and Scales rating; Examples taken
from current clinical and experimental practice; Different methods of administration.
- Main epistemological problems:
Latent and fully observable variables; "reflective" and"training"; Causal or co-variation relationship between latent variables and observed
behaviours; Difference between evaluation (multidimensional decision-making) and true measure (one-dimensional process)
- Ideal properties of the measure: Unidimensionality; Discrimination (linearity, precision, targeting-accuracy, floor-to-ceiling effect);
Estimation of missing scores; Not redundancy (cancellation of "Jackpot"); Invariance across sub-groups (including intra-inter-observer
repeated measures); Possibility of correction according to the severity of the examiner
- The concept of the"validity"of the measure.
- Scores and measurements. Distortions induced by raw scores (raw scores).
- From counting to true measurements: from traditional test theory to modern item response theory:
Observed scores (Observed-raw scores) and scores expected from the theoretical model (expected scores); difference between expected
and Observed scores: "residual" and data-model fit; maximum likelihood estimation: maximum does not mean great; Georg Rasch's
original dichotomic model: prescriptive, non-descriptive Rasch-derivative models: scale rating (Andrich model), partial-credit (Masters
model) and many-facets
- Solutions offered by Rasch models: Linearity; Single response error estimates; internal coherence estimates in response profiles; LAPMER
scale; missing values estimates; data-model fit; stability of item challenge hierarchy among subgroups; differential item functioning and
differential test functioning correction through item-split
In particular: solution to the problem of translation across different linguistic contexts (metric vs linguistic equivalence). McGill Pain
Disability Questionnaire and BACKILL scale; Multiple examiners mis-fit: FISM-ProQual™ for research projects evaluation
- Examples of frequently used scales with limited validity
- Example of scale construction (ABILHAND) based on Rasch criteria
- Video Examples of manual performances; comparison between visual evaluation of abilities and measurement through ABILHAND
- Use of nomograms to graphically convert scores of linear measures; missing values; software freeware MINISTEP™.
- Evaluation profiles through scales; example with upper limb functioning
- Behavioral measures based on instrumental measures of performance (e.g.strength; balance): advantages and limits vs
questionnaires. Subjectivity and objectivity in psychometric or behavioral measures

- Technological tools and equipment that can assess and quantify functional damage: motion analysis, inertial
sensors, sensor prostheses; Robotics and virtual reality in rehabilitation; Skeletal muscle modelling: simulation of
movement based on data collected by the patient.
- Planning of functional surgery, applications of neuromuscular electrical stimulation
The system of European research organisation in rehabilitation.

Natural immunity response
- Natural immunity cells
- Cell modifications during the response of natural immunity: Cellular activation (prr, nfkb and its adjustment);
Macrophage activation (m1, m2)
- Vascular changes during natural immunity: Vasodilation; Increased permeability
- Leucocitary recruitment: Membership (molecules involved)
ChemotaxIs
- Mediators
- Chronic inflammatory response
- Adenosine; Functions of adenosine
Tumors
- Benign tumor and malignant tumor; Genes involved in the genesis of cancer; Molecular bases of oncology;
Characteristics of the cancer cell: neoplastic progression; Angiogenesis; TranscriptIon Factor hypoxia
inducible factor 1: adjustment
- Techniques described: Cell cultures; Western blot, qualitative and quantitative analysis of protein

- Basic principles of scientific research (hypothesis, experimental phase, discussion of results)
- Overview of epidemiology, risk factors and nomenclature of cancer pathology
- Overview of the diagnostic procedure of cancer pathology, screening tests and new diagnostic and screening methodologies
-Clinical studies and their value, observational/experimental, cohort studies, case-control studies, randomized studies
-Phase I studies in oncology: goals, methods, interpretation of results
-Phase II studies in oncology: goals, methods, interpretation of results
-Phase III studies in oncology: objectives, methods, interpretation of results
- Phase IV studies
- Study with historical controls, limits and applicability
- Studies of non-inferiority
- Metanalysis, limits and applicability
-Planning a clinical trial (inclusion/exclusion criteria, informed consent, ethics committee)
-The impact on the clinical practice of studies in oncology